COMPARATIVE STUDY BETWEEN DICLOFENAC SUPPOSITORY AND COMBINED ORAL DICLOFENACWITH LOCAL ANAESTHETIC AGENT IN PAIN MANAGEMENT IN ACUTE FISSURE IN ANO IN OUT PATIENT DEPARTMENT CARE

Abstract

Introduction: Anal fissure is a common problem that causes significant morbidity in a young and otherwise healthy population. Acute fissure in ano is a very common problem faced by Indian population. Though it is a very common problem still the pain relief has always been an unsolved issue. There are various pain management modalities for fissure in ano. The objectives of this study is to evaluate and compare the efficacy of diclofenac suppository versus combined oral diclofenac with local anaesthetic agent in prevention of pain in acute fissure in ano and to achieve an effective, cheaper and an easy method to relieve pain in patients with acute fissure in ano in Out patient department care. Diclofenac suppositories are opted as they are easily available and patient could insert it without anyones assistance and hence not hospitalized for intravenous administration of analgesics. Methods: A study was conducted over 100 cases over a span of 1 year in a tertiary health care centre. Group A patients were treated with Diclofenac suppository 100 mg twice a day for 5 days with glycerine for lubrication at anal verge and Group B patients were treated with Oral Diclofenac 75 mg twice a day for 5 days plus Lignocaine Jelly for local anaesthetic. The pain score was noted in both the groups. All acute fissure in ano cases were included in the study. Results: The pain score of Group A cases was significantly lower than Group B cases. Conclusion: It was noted that the pain relief was significant in patients in Diclofenac suppository alone compared to combined Oral Diclofenac and Lignocaine jelly and thus we can achieve significant pain reduction on Out Patient Department basis with Diclofenac suppositories alone within seven days. Thus an effective, safe, cheap and an easy modality for pain relief in acute fissure in ano with good results could be achieved.